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HomeMy WebLinkAboutInsurance Certificate: Diamond Parking ACORDCERTIFICATE OF LIABILITY INSURANCE OP ID GD DATE(MMIDDNYYY) DIAMO01 07/14/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lovsted-Worthington LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 607 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. hell WA 98041 _one: 425-486-1291 Fax: 425-486-6140 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Chubb Custom INSURER B: Federal Insurance Company Diamond Parking Inc INSURER C: Employer's Insurance Wausau 605 First Ave Auite 600 INSURER D: Scottsdale Insurance Company Seattle WA 98104-2224 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER P LI Y EFFECTWE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE DATE (MMIDDNY) DATE (MMIDDIYY) GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY 79572244 07/15/09 07/15/10 PREMISES (Ea occurence) $ CLAIMS MADE Fx I OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,000,000 POLICY JE PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B ANY AUTO 73547935 07/15/09 07/15/10 (Ea accident) $ 1,000,000 X ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $150,000 A ANY AUTO 79572244 07/15/09 07/15/10 OTHER THAN EA ACC $11000,000 AUTO ONLY: AGG $1,0001000 EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 2 , 000 i 000 D X OCCUR El CLAIMSMADE XLS0060951 07/15/09 07/15/10 AGGREGATE $2,000,000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY C ANY PROPRIETOR/PARTNER/EXECUTIVE WCC-Z91-452389-019 07/15/09 07%15/10 E. L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 1 000 , 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Station #EA01 - City of Ashland, Ashland, OR 1 2009 Certificate holder is an additional insured JUL 4 ( m~ CERTIFICATE HOLDER CANCELLATION MHI A01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Ashland IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 E Main Street Ashland OR 97520 REPRESENTATIVES. AUTH PRESE ACORD 25 (2001/08) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108)